11180 SW NORTH DAKOTA STREET •l Ll 9l tl Yl Cl ZI ll Ol
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11180 SW North Dakota Street
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LEONARD A. RYDELL, P.E., P.L.S., W.R.E. Consulting CMI Engineer-land Surveyor
j 601 PINEHURST DRIVE, NEWBERG, OREGON 97132-1625
(503) 538-5700 FAX 538-9167 y t
! 27 June 1996
D rc r �
Arthur Torland
8520 S. W. Avery Street ,1UtV Fi 19g�,
Tualatin, Oregon 97062
CITY OF TIuARD
Re: "TORLAND ESTATES"
Dear Mr. Torland:
Enclosed for your information and use, please find a copy of the Invoice
from Schulz Sanitation for the pumping of the Septic Tank at-144-7".
W. North Dakota Street. 1
Should you need additional information, please let me know, and if you
have any other questions, please feel free to give me a call.
{ Thank you.
1
Sincer ly yours,
Leonard A. Rydell, P.E., P.L.S., W.R.E.
L AR/j
enol: as stated
cc: Renaissance Development
G. V. S. Contractin
I
PLANNED DEVELOPMENTS . RESIDENTIAL SUt3DMSION
WATER, SANITARY SEWER AND STORM DRAINAGE SYSTEivi-
LAND SURVEYS WAT[R RIGHTS
AL6 AMA
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SIGN PERMIT
! DATE ISSUED. . . . ... 12/23/94
PERMIT # : SGN94-0211
a EXPIRATION DATE: 3 ,�22 /q,5
PARCEL. . . . . . . . . : 1S134DB-TE001
ZONE. . . . . . . . . . . . R-4 . 5
BUSINESS NAME. . : RENAISSANCE DEVELOPMENT
SIGN LOCATION. . : 11180 SW NORTH DAKOTA ST
APPLICANT/AGENT: RANDAL SEBASTIAN
BUSINESS TAX NO: _
SIGN:
PERMANENT (X) FREESTANDING (X) FREEWAY ( )
TEMPORARY ( ) WALL ( ) ELECTRONIC ( )
{ OTHER ( ) BILLBOARD ( ) BALLOON ( )
i
SIGN DIMENSIONS . . . . . . : 2' X 16'
TOTAL. SIGN AREA: : ; ; : : : 32 sq• f� •
WALL AREA. sq. ft .
WALL FACE (DIRECTION) : NE
SIGN HEIGHT. : 6 ft .
a PROJECTION FROM WALL. : in.
ILLUMINATION. . . . . . . . . : NON
DESCRIPTION OF SIGN:
Subdivision monument sign: 2' x 161 , brick with brass lettering "TORLAND ES+
J MATERIALS . . . . . . . . . . . . : BRICK/BRASS
EXISTING SIGNS. . . . . . . : 1
ELECTRICAL PERMIT REQUIRED: NO
BUILDING PERMIT REQUIRED. . : NO
ADMINISTRATIVE EXCEPTIONS . : r;,A
PERMIT FEE : $ 25 . 00
APPROVED BY:
DATE : 12/28/94
^ x M \\ 'W11GWW MWPtv+IR - - ,.•.
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W�AKYlIMIM�W"tM4Wf.Ail1MNWKtIn...-...... n .L-(.
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Permit No.
CITY OF TIGARD
SIGN PERMIT APPLICATION
The applicant hereby applies for a permit for the work indicated or as shown in the
accompanying plans and specifications. /,q--d-
SIGN LOCATION ADDRESS �QYN�'V 0- s�1/�CJ/J�I ,��df/1 / Al- 7
ZONIIJG:
NAME OF BUSINESS:
APPLICANT/AGENT: �r�/5� � rr�il(9 ANSr: d- �/ PHONE:
The'City of Tigard imtoses an anrtlal Business Tax which must be kept current on all
persons doing business in the City. Do you presently have a current business tax?
YES ( ) NO ( ) U.L. Label if 3
PROPOSED SIGN: (Check as marry as apply)
PE RWENT FREEsrArII n4G (X) FREEKAY
OZHER ( ) x IIZOA D ( ) BALLOON ( )
SIGN DIMENSIONS: X llv E XPIRATTON Dim:
TOM SIGN AREA (Sq. Ft.)
WATL AREA (Sq. Ft.) : L G�
WALL FACE:
HEIGHT (Ft) :
PRQTDCTION F jag WAIL:
ILUM114AT'ION: YFS ( ) NO (}C) TYPE:
MATERIALS: i
aasrnc SIGNS: /bc°rVr
ACA MsmATIVE EXCEPTION: N/A ( ) APPROVED ( ) HOW M[XH % ^^ f
AREA ( ) HEIGHT ( )
DEPARTI�Nf All sign permits must be ac=upariied by a scale
hWjj, ;;L(,-7),(:Q_ Cn c 1 drawing and plat plan. If work authorized under
's &MiPNg; CAq ���� b� a sign permit has not been completed within ninety
AP02mmd By; C^ days after the issuance of the permit, the permit
Date• \p--? - shall become null and void.
E 19=J<7L PERMIT I C R= THAT_-X;",;
',y"y THE: RDCI2DID OWNER OF 'IIIE
REQUIRED: YES ( ) NC. (✓ PROPERTY ORAW A1MiORI.=,BSf
BUILDING PERMIT
REQUIRED: YES ( ) NO ('v) Appli.cant'd Sigmturef
Cp/BEQTE � _.
N:\WORD\CCI DEv\ 'Pel atx�
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SEP — 9 - 9 .1 I' 1IU It : 07 1_ E011f'1121) 0 _ R V DELI— PE PLS P . 01 '
•� CENIERLINE S.W. NORTH DAKOTA
S89'51'28"E 1532.45 a BASIS OF BEARINGS
--NORTH - -DAKOTA-- STREET•--
1092.37' (8 41 M)
9051'28"E 128.80 p t5e.s9'�_ S89-51028 108.59 -
108 47 20.33' 95.00' -10.00' _ _ 10.00'-
1 =14.QQ "_E'�ff 1 11 I �� - - SB9�51_WE
S89'S1'2o
w l 1 ADDITIONAL 9' P LIC
B' PUDUC E;#
RIG T-OF-WAY UTl
UTILITY I `; �. ; dEDI TION �MENT r
n EASEMENT 16 8 `► `1'.)', 1 y
ra
8,526 5q.FT. I� 2E, 17.
i d �
o � I A� r-•,I
o {�t l EE 0 20 9
W $ I z lJ I M 7, 1 S F'
N89 37 37 E �_. N I N �1
JJ
95.00' » 7.59 M
to H,54J SU.F i. Ir , MI
I��; T� S89 51 28 q� 3 S89'S1'2 '.E_ 105.71
*� 0 17 NI [:31 589'61'28•E
00'
9. `
z I o 71.82'-^ —� 80.00 81.09
V---
[" N89'037"E 1 ( 110' PRIVATE 10' PRIVATE
I 80,88' 1i I STORM DRAINAGE STOPM DRAINAGE (V �
lug' I ''1 EASEMENT FOR EASEMFNT FOR b;
�-I LOTS �AND 10 LOT 10 � e� 1 o
I I ilk 9,048 SQ•FT, 7,675 SQ.FT. 1,739 SQ.FT.
N 3 I 'c[ c�
N F116156- SQ.FT. I V) L.-9' U ill_ITY o ;y
EASEMENT\zj 25.00' 26.00' I Y Z
80,00 yT P0.00 _
g 89.80
C S.W. TORLAND SINEET v
'3 I �'. /� S89'S8'38"C 21`'•20'
,� C t1i'li?1' �q'58'3H"E 327.20' ��
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_-------
�_� INVOICE Complete
10643 N.E.Simpson Industrial
Portland,Oregon �AGuJ�, S �'� \YN ? `� waste
97220 1 14?()f? Septi Removal a k Cleaning
Sump
Line Cleaning {
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023255
I 5*SAN�lOIN
1
DBA McInnis Ent.1_td.Co. Q
(503) 253-7587
1
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Customer P.O. #—_ ___-�-----'-----
Date
Billing Name
Address ------
_ Job Site#
--_ � ---- Zip Code 1
City
I e Date
Ordered By
Job Location
Service Call
--- $-------.T_ --
Labor_
Pumping, i gallons -- - --- -- __
Misc -
{ Conditions of tank/Distribution Box -- -
TOTAL CHARGES
Schulz Sanitation is in no way responsible for damage In the septic tank or lids on the system.
TERNS:Net 10 days.1'/,%per month will be charged on past due accounts.(18%per annum)
1
Customer's Signature: ---
. . . - - Date _
Service Driver's Signature _ Time____ __
I
TERMS AND CONDI rIUNS ON REVERSE SIDE REDEEMABLE IN MULTNOMAH COUNTY
{ 4
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TERMS & CONDITIONS
THE CUSTOMER AGREES TO PAY ALL INVOICES ARISING OUT OF
PUMPING SERVICES, AND ANY OTHER SPECIAL SERVICES HEREIN f
WITHIN 10 DAYS FROM THE DATIL OF INVOICE.
r
THE CUSTOMER AGREES TO . PAY SUCH EXTRA & OVERTIME
CHARGES AS MAY BE INVOICED FROM TIME TO TIME FOR SERVICES
RENDERED, OVER AND ABOVE THE NORMAL SERVICING SCHEDULE, I
ON BEHALF= OF THE CUSTOMER.
THE CUSTOMER AGREES TO ASSUME. RESPONSIBILITY FOR ANY
DAMAGE TO CUSTOMERS OWN REAL OR PERSONAL PROPERTY
ARISING FROM PUMPING SERVICES WHICH TAKE PLACE ON CUS-
TOMERS PREMISES, WHERE THE DRIVERS AND VEHICLES OF
SCHULZ SANITATION HAVE BEEN INS'f RUCTED TO ENTER. THIS IN- r,
CLUDES, BUT IS NOT LIMITED TO DRIVEWAYS,TREES, POWER LINES
OR POLES, AND BUILDING STRUCTURES.
IF SCHULZ SANITATION FINDS IT NECESSARY TO ADD LIQUID TO THE
TANK ON JOBSITE:, CUSTOMER WILL BE CHARGED FOR,THE ADDI-
TIONAL GALLONAGE RESULTING FROM THESE CONDITIONS.
CUSTOMER AGREES TO REIMBURSE SCHULZ SANITATION SERVICE
FOR ALL REASONABLE ATTORNEY'S FEES, COURT COSTS AND
OTHER EXPENSE INCURRED BY SAID COMPANY TO ENFORCE COL- ,
LECTION OR TO SERVE THEIR RIGHTS UNDER THIS AGREEMENT.
CUSTOMER AGREES TO THE ABOVE CONDITIONS.
REDEEMABLE IN MULTNOMAH COUNTY,
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U.71 T77 7-mrTF FT TR
CITY OF TIGARD BUILDINU PERMIT
COMMUNITY DEVELOPMENT DEPARTMENT
PERMIT #. . . . . . . Nu.='9ti -4!x239
13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 DATE ISSUED: 08/16/94
6:39-41 71
PARCEL: 1 S 1,-34DB-02800
S I TE ADDRESS. . . 11. 180 SW NORTH DAKOTA ST
SUBDIVISION. . . . : ZONING: R-4. 5
BL.00I.. . . . .. . . . . . LOT. . . . . . . . . . . . . .
REISSUE: FLOOD AREAS--- ---- - EXTERIOR WALL CONSTRUCTION-
CLASS OF WORK. :DEM FIRST. . . . : sf N: S: E. W:
TYPE OF USE.. . . :GF SECOND. . . : sf PROTECT OPENINGS?---•-----.-.—_.--
TYPE OF CONST. :5N THIRD. . . . : sf N: 5: E: W:
OCCUPANCY GRP. :R;3 TOTAL-------: 0 sf ROOF CONST: FIRE RET'? :
OCCUp'ONC:Y LOAD: BASEMENT. : sf AREA SEP. RATED:
STOR. : HT. : ft GARAGE. . . :355 sf OCCU SEP. RATED:
NSMT? : I1E:Z Z? : REUD SE]'BACKS------ REULI IFLOOR LOAD. . . .LOAD. . . . ps f LEFT:9 f t RGH T : ft F I R SPKL_: SMOK. DET. . :
DWELLING UNITS: F-RNT:23 ft REAR: 15 ft FIR ALRM: HNDICP ACCs
DLDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
_UL. $ : 0
Remarks : Sewer-, to be crapped & inspected/ all densis ml_ist be removed. CREDITS FOR
TIF•, SEWER, PARKS, STORM '.SDC: WILL APPLY TO NEW HOME.
Owner; -.._.__ -__.._.____.-- ---._._.._---._____________._.__..____.__..___.___..-- FEES
RENAISSANCE DL-:VELOPMENT CORP type amount by date r'e.c.'pt
1672 SW WILLAMETTE FALLS DR E'RMT $ 25. 00 JG 08/16/94 — '
WEST I._INN OR 97068
Phone #:
Contractus^•
GVS
u
3815 COFFEY LN
P'{'h'�
NE:WBERG OR 97132 _.__________.___..______.___.____._._..________ � r til,.
Phone #: $ 26. 25 TUT AI_ `
{ Reg #. . : J4;:,40
--- REQUIRED REDUIRE.D IN,SPECTIONr -- --- -
This permit is issued subject to the regulations contained in the Cap sewer, line
Tigard Municipal Code, State of Ore. Specialty Ccdes and all other Final Inspect ion
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 18N days of issuance, or if work is suspended for sore
than 10 days,
F�'fiwrr
i_"ermittee Eignat,ar-e .
Issi.ted By:
Call for i.nspec.tion 639--41 '15
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( . Residential Building Permit Application
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 I
(503) 639-4171
i
Jobsite Address: 11180 SW North Dakota
Office Use Oniy
1 Subdivision: Iorland Estates Lot# 1
Valuation: 0 Planck/Rec #
�
Corner Lot? YYN Permit#
Flag Lot? Y N Reissue of
Map &TL#
Owner: Renaissance D_vclupmew Approvals Required
Address: 1672 S.W. Willamette Falls Dr. Planning _
West Linn OR._ 97068 - Engineering
I
Phone: (503) 557-8000 Other
Contractor: c.V.S Contractinu Inc. Items Regulred
I
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Address: 3815 Coffey Lane - Subcontractors
I Newberg, OR 97132 _ _ Trusr Details
Phone: _ — Otiler
Contractor's License #
(attach copy of current Oregon licf r,,
Contact Name & Phone: Randy Sebastian 551-8000 —
Subcontractors: Architect/Engineer: ___N/A
Plumbing: _ N/A Address:
Mechanical N/A
(attach copy of current OR Contractor's License)
Phone:
JOB DESCRIPTI Remoya]_ of an of home
Appl cant Signature & Phon be
Received by: G Date Received:
N'.MORMCOMMARE SAP P
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Permit# Account Description Amount Amt. Pd. Bal. Due -
Bldg. Permit (BUILD) — -
Plumb. Permit (PLUMB) I
Mach. Permit (MECH)
State Tax (TAX)
Bldg:
Plumb: _ I
Mech: _
Plan Check (PLANCK) _—
I
Bldg:
Plumb: — —
Mech:
r
Sewer Connection (SWUSA) -- --- �'
Sewer Inspection (SWINSP) —
Parks Dev Charge (PKSDC) —
i
Storm Drainage Chg (SDSDC) —
Residential TIF (TIF-R)
Mass Transit TIF (TIF-MT)
Commercial TIF (TIF-C) ---
Industrial TIF (TIF-1) — -
IInstitutional TIF (TIF-IS)
Office TIF (TIF-0)
Water Quality (WQUAI_)
Water Quantity (WQUANT)
Fire District (FIRE)
Erosion Cntrl Permit (ERPRMT) _ _—
Erosion Planck/USA (ERPLAN) —
Erosion Planck/CO1' (EROSN) _ —_--
TOTALS: ��� �....�.�..
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GHF.CK AMOUNT a ,.F,» 05 1
fdNMF: c HF"NA I S''ANC E ))FF.'VF.T.gF'MkN I CASH AMCKIN"f 1 ur» ola
HILI")N,F: 3ti 1 PAYMENT' DATE 1 09 1.6/94 l
31JUD I V 18 I UN e
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INSPECTION NOTICE
City of Tigard Building Departaent
13125 SN Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections 1 �� J'- <..--: . __�CJ✓ ^J'./: __ �..—
lootihq-1 ?lbg. U.4e'rslah Mech. Rough-in Appr/Sdwlk
bound. l Plbg. Top Out. Gas Line FINAL:
Post/Beam 3truct. San. Serer Framing -Bldg. w •
Post/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. Bd. Ze(Date Requested: �^ -- TTimesAN PM
Address:-Ji ( Y �� l.tJi /)- �- /-�l Q tPres'�it �t I C GO��OQ� y
Builder: C•i.- ('
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inepectort/�Kl�_. -- ---- ---- Date:_ -Z.® 'y -2-
APPROVED _- DISAPPROVED APPROVED SUBJECT TO ABOVR
__Call For Reinsp.
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CITYOFTIFARDBUILDING FSE RM I
Cf1YOFTMRD f--11--R11I T #. . . . . . . . BUI-192—•0008 {
COMMUNITY DEVELOPMENT DEPARTMENT 02140e+
1316c.dW Hall Blvd. P.O.13=29307,TOW,OrOW 07223(Tx 54 417 1 DATE ISSUED: 01 /17/92
SITE ADDRL-5S. . . . 1 1 J.i' NORTH DAKOTA ST IDARCEL_: 1 S 134DB-•+Z+c_£i00
SUBDIVISION. . . . : ZONING3 R--4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :
------------------------------------------
REISSUE: FLOOR ARI`Aa' ----_-- EXTERIOR WALL. CONSTRUCTION-
CLASS OF WORK. :NEW FFIPST. . . . : S N: S: E: W
TYPE OF USE. . . :SF= SECOND. . . : s f PROTECT OFTEN I NGS?--•-----______
TYFIE OF CONST. :5N THIRD. . . . - sf N: E. W:
OCCUPANCY GRP. :R..?I TOTAL--- - ---: 0 s.f RC1OF= CONST: FIRE RE:'T? :
OCCUPANCY LOAD: BASEMENT. : sf AREA CEP. RATED-
ti T OR. : HT. : ft GARAG)E. . . ::'s�;`� s f OCCU s[:F1. RATED:
BSMT?: IVIE-Z L?: RLOD
FLOOR LOAD— . -- ps f L_EF'T:9 ft RGHT: ft FIR SP,KL: SMOK DET. . : t
DWELLING UNITS: FRNT:c.'3 ft REAR: 15 ft FIR ALRM: HNDICFI ACC:
IAEDRMS: SATHS: ?v+P SURFACE: PRO CORP. PARK I N(:•i
VALUE:. $: 200
Remarks: moving in gar,agv to be placed on new foi_+ndation
Owner,: _._._ _._ ___._____ ._.___....___ __.---_.___.__-._ __.._..___ ...._..-_- _.____ FEES
ART & BE•SSIE TORL_AND type amor_rnt tbv date recpt
8520 SW AVERY PRMT $ 25. 00 JLH 01/16/92 -
PLCK $ 6. 25 JLH 01/16/92 -
TUALATIN ORP CT $ 1. 25 JLH 01/1h/92' -
Phone #: 692-3613
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Conti-ar.tor-:
f:)W N F^F
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f-'hone #: $ 32. 50 TOTAL_
REOUIRED INSPECTIONS
This pe','sit is issued subiect to the regulations contained in the Foot/fol_rnd Insp _•. „____ �_�_.__
+icard Municipal Code, Mate of Ore. Specialty Codes and all other Fin-il Inspection �-
applicable laws. All .fork will be done in accordance with
approved plans. This persit will expire if work is not started
within 180 days of issuance, or if work is suspended for sore
than 180 days.
P e r in i t t e e S i r.I p a t +r : ___ ____._._ ------
I s s 1.t i-,d
__.Iss1.rr.,d By
Call for inspection - 639-4175
�' ref
13123 SW Iiall Blvd. PLNCK/RECT
CITY OF TIGARD T, PO C on 972D PERMIT # Bu -2-6,136 $
COMMUNITY DE��ELOPAIENT DEPARTMENT Ea S
(503)634171 DATE ISSUED _
,,�-� ��p j TAX MAP LOT /SJ .34 pg U�eyo
JOB ADDRESS: � � �Sd S��� lI��y�am• �' MAP/
LOT
1QZLrtA-.)D CS TA L0T: LAND USE: f
':ALUATION:
---
eWN" SPECIAL NOTES
NAME: AeT-4 ,g /E- T012U9/V-D REISSUE OF:
ADDRESS: ��Z�� S, L[I ��� LAST REISSUE:
o rL FLOOD PLAIN/
PHONE: Z` 3 3 _ SENSITIVE LAND:
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CONTMCTOR (� APPROVALS RE U I RED
NAME: _ se \) PLANNING:
ENGINEERING:
'
ADDRESS: - —
FIRE DEPT:
PHONE: OTHER:
1 CONTR. BOARD a: EXP DATE:
ITEMS REQUIRED f
_SUBCONTRACTORS: PLUMB: _ _ __ LIST/SUBCONTRACTORS:
MECH: _ BUS TAX: _
ARCH/ENGINEER CALCULATIONS: _
j NAME: TRUSS DETAILS: _
ADDRESS: OTHER:
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PHONE: --
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PROPOSED BLDG. USE: C�r(� S��2E>�T ra�T (2 -PA ltCX<I Aj G
COMMENTS: P400 I AJ C- 1313 14D 0010 /a� /r��•�%�sS�� S" r --
=i %ff-7 r � �1ur%t� - rM/'Gr�A,y� Ff1 A iFAe u•v _ _
�f1PLICANT SIGNATURE
Peceived By: ___-----_ . —.� _^ Date Received: — --_------ --
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Ak—
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pµ. � ." � AMOUNT AhiOUNT PD. BAL. DUE
PEP.r11T F" ACCT r DESCRIPTION
&,Pyt"cr�u� 10-432 00 Building Permit Fees
10-431 00 Plumbing Permit Fees —
10-431 01 Mechanical Permit Fees
10-230 01 State Building Tax (5%) Z a
Building L i
Plumbing
Mechanical
10-433 UO Plans Check Fee �—
Building
Plumbing
Mechanical _
10-230 06 Fire -
30-202 00 Sewer Connection
30-444 00 Sewer Inspection
25-448-02 Commercial TIF Fees —
25-448-04 Industrial TIF Fees
25-448-06 Institutional TIF Fees -
25-448-03 Office TIF Fees
i
25-448-01 Residential Traffic Fees
25-448-05 Mass Transit, TIF Fees
52-449 03 Parks System Dev Charge (PDC)
31-450 00 Storm Drainage Syst Dev Chrg
(SSDC) __-
24-445-01 Water Quality (Fee in lieu of)
24-445-02 Water Quantity (Fee in lieu of) _
TOTAL J32,S V _ ��, S D
nm/35871).WPF
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IF �,� Permit No:
Address:
Issued by: Date:
— FOR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be Issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
e
Fill In the applicable blank:c, P.nd Initial box 1 and either box 2A or 2B:
1. ] 1 own, reside in, or will reside In the completed structure.
2. A. D My general contractor is
Contractor registration number
I will Instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
B. [ ] I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. 'f I change my mind and do hire a general
contractor, I will contract with a contractor who is registered with the
Construction Contractors Board and I will Immediately notify the office
Issuing this building permit of the name of the contractor.
I hereby certify that the above Information is correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
CSlgrfature of Permit Applicant 'at e ` 7
CONSTRUCTION CONTRACTORS BOARD
0244J 1190
WHITE COPY TO ISSUING AGENCY PERMIT FILE f
PINK COPY TO APPLICANT
r '
cy •
Ac
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This Information Notice to Property Owners About Construction
Responsibilities was developed by the Construction Contractors Board in t
accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature.
If you are acting as your own contractor to construct a new home or make a substantial improvement
to an existing structure, you can prevent many problems by being aware of the following responsibilities
and areas of concern.
EMPLOYER RESPONSIBILITIES: �
It you hh,Q persons riot registered with the Construction Contractors Board to do labor in constructing
or assisting In the construction or improvement of a residential structure, you will, in most instances,
be ruled to be an "employer" and the people you hire will be "employees". As the employer, you must :,
comply with the following:
Ore�ggo����n__'s Withholding Tax Law: As an employer, you must withhold income taxes frum employee wages
at X— employees are paid. You will be liable for the tax payments even if you don't actually withhold
the tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390.
UnerT!pI2yn1ent Insurance Tax: As an employer, you are require,-! ,c pay a tax for unemployment insurance
purposes on the wages oTaTemployees. For more information. call the Oregon Employment Division DHR
r
at 378-3224.
Workers' Gom2ensation Insurance: As an employer, you are subject to the Orugon Workers' Gompensa-
I tion Law, ancfimust a twin workers' compensation insurance for your employees. If rou fail to obtain workers'
compensation insurance, you may be subject to penaltie3 and will be. liable for all claim C'gists if one of
your ernployees is injured on the job. For more information call the Wurkers' ComFensation Division DIF
at 3737434.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees'
wages 5'ou will be liable ar the tax payment even If you didli't actually withhold the tax. For more informs•
tion, call the Internal Revenue Service at 221.3980.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code Compliance: As the permit holder for this project, you are responsible for resolving any failure ,
to meet code requirements that may be brought to your attention through inspections.
Liability and Property Dam_ Insurance: Contact your insurance agent to see if you have adequate
Insurance coverag__e__ff__or accc encs an omissions such as failing tools, paint overspray,water damage ;
from pipe punctures, fire, or work that must be re-done.
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Time to Supervise Employees: Make sure you have sufficient tirne to supervise your employees.
Expertise. Make sure you have the expertise to act as your own general contractor, to coordinate
the woof rough•In and finish trades, and to notify building offic►a1s at the appropriate times so
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they can perform the required Inspections.
If you have additional questions. write toi Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503.378.4621
0244J 10!24189
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CITY OF T I G'?ORD — RECEIPT OF PAYMENT RECEIPT NO. s�3��—�:�:4_�►S�(, �
CHECK. AMOUNT a 0. 00
NAME s DrrSL.I�., HANK
CASH AMOUNT a
ADDRESS s PAYMENT DATE a 1
SUBDIVISION a
91
PURPOSE+OF PAYMENT AMOUNT PAID F.IURPOSE OF PAYMENT- AMOU I PAI V
1
BUIi_E:�ING PERM 25.Dia PLAN CHECK FE 6. 25
may,T+ BUILD. . t
`a PER • 25 `
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ITIQ._AND
111810 SW NORTH DtaKOTA
TOTAL. AMOUNT PAID
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